KIMBERLY E HENDERSON (APRN, CNP) – Nurse Practitioner, NPI 1114991361
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
Provider Addresses for KIMBERLY E HENDERSON (APRN, CNP)
520 NW 5TH ST
BRAINERD, MN 564012902
Phone: (218) 829-3235
Type: Mailing
PO BOX 667
BRAINERD, MN 564010667
Phone: (218) 851-3862
Fax: (651) 628-0411
Type: Mailing
13417 CYPRESS DR
BAXTER, MN 564258253
Phone: (218) 828-2027
Fax: (218) 829-1473
Type: Location
110, Silver Lake Road Northwest, New Brighton, Ramsey County, Minnesota, 55112, United States
NEW BRIGHTON, MN 551121789
Phone: (651) 628-9566
Fax: (651) 628-0411
Type: Mailing
Atrium Professional Building, 401, 16th Street Southeast, Golden Hill Industrial Park, Rochester, Olmsted County, Minnesota, 55904, United States
ROCHESTER, MN 559047973
Phone: (507) 516-0030
Fax: (507) 516-0031
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $37.
Total Amount is formed as General ($37) + Research ($0) + Ownership ($0) = $37.
Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Alkermes, Inc. ($24).
Total Amount
$37
General + Research + Ownership
Payments
2
Total payment records
General Amount
$37
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alkermes, Inc. | $24 |
| Otsuka America Pharmaceutical, Inc. | $13 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-03-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240301001092 | I | Nurse Practitioner | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 56401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | TN | |
| - | AK | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | WA | |
| Nurse Practitioner | NM | |
| Family Practice | ME | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | AK | |
| Nurse Practitioner | KS |
Reviews
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